Skin cancer screening in organ transplant centres in the United Kingdom: a national survey

Abstract

Organ transplant recipients (OTRs) have up to 500-fold increased risk of keratinocyte skin cancer (KSC). International guidelines recommend at least annual skin cancer screening for OTRs. To explore the current skin cancer surveillance practice in UK transplant centres across all solid organs and the barriers to surveillance. An online survey was sent to all 59 transplant centres in the UK specialising in kidney (n = 24), pancreas (n = 10), heart and/or lung (n = 13), liver (n = 8) and intestine (n = 4) transplants. Fifty-one (86%) transplant centres responded. Twenty-eight (55%) centres provided skin cancer surveillance post-transplantation, of which 18 (64%) had a non-skin cancer specialist providing screening. Only 21 (41%) units performed a full skin examination. Eight units (29%) screened at least bi-annually in the first five years post-transplantation. Of the 23 (45%) centres that did not provide skin cancer surveillance, limitations included: reliance on patient-reported lesions (48%), lack of skin surveillance training (30%), lack of funding (48%), not a requirement in all patients (17%) and time restraints in the clinic (30%). In the UK, many transplant units do not provide skin surveillance. Collaboration between skin cancer and transplant specialists would improve surveillance rates and reduce morbidity and mortality.